Assessing Cultural Factors and Skill Utilization Among Latina Clients: A Two-Series Case Study Examining the Unified Protocol

Co-morbid anxiety and depressive disorders are common, especially among Latines. Fortunately, research supports the use of transdiagnostic treatments with Latines. Studies have found that the Unified Protocol (UP), a transdiagnostic treatment, effectively targets co-morbid anxiety and depression among this population. Currently, there is limited information about cultural factors associated with treatment outcomes for Spanish-speaking Latines treated with the UP. The UP does not provide nuanced information about skill application in everyday life; therefore, the frequency of skill use among this population is currently unknown. Ecological Momentary Assessment (EMA) uses daily prompts to assess behaviors in daily life and can bridge the current gap in the literature. In the present case study, two Latina clients were treated for co-morbid anxiety and depression utilizing the UP and were prompted daily EMA questionnaires to track the frequency of skill use. Cultural factors that impacted treatment were thoroughly explored. This case study found numerous cultural values (i.e., familismo , marianismo , simpatia, religión , colectivismo , respecto ) that influenced the client’s treatment progress and discussed how the UP was used to realign the client’s behaviors with their cultural values. Both clients experienced a reduction in anxiety and depressive symptoms post-treatment, however, according to the EMA questionnaires, skill use was low. Skill use was reported high within treatment sessions, therefore, EMA in its current format is not the most viable option to collect daily information from Latines with complex lives. The interplay between the UP and cultural factors offers insights into treatment progress when treating Latine clients.